| NPI | 1235738576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY THOMAS BORTZ Authorized Official 925-932-7704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |